S06-3 Supporting our lifelong engagement: mothers and teens exercising (SOLE MATES); from formative research to feasibility testing

Abstract Background Health promotion efforts have largely failed to effectively support adolescent girls to meet public health guidelines for physical activity (PA). Engaging mothers in the promotion of PA for their daughters is an important strategy to facilitate behaviour change. This paper provides an overview of the development of the SOLE MATES programme - a novel mother-daughter intervention. Methods This programme of research follows the MRC guidance for development and evaluating complex interventions (Craig, 2008). Two reviews were conducted to synthesise the evidence base on (1) mother-daughter PA interventions and (2) adolescent girls' perceptions of PA participation. The behaviour change wheel (BCW) framework was then used to design the components of an intervention to improve adolescent girls' PA (Michie et al, 2011). Finally, a single-arm feasibility trial was conducted to examine recruitment, data collection, acceptability, resources and participant responses. Results Our evidence reviews showed that only a limited number of interventions designed exclusively to target mothers and daughters have been conducted. In addition, programmes for adolescent girls should focus on alternative activities aside from the competitive team-based sports often offered. The BCW design process resulted in a group-based face-to-face intervention, involving six intervention functions (education, persuasion, incentivisation, training, modelling, enablement) and 18 behaviour change techniques. The 6-week programme includes weekly educational and practical group sessions plus home tasks and the provision of participant resources. In addition to encouraging participants to walk regularly, the programme also aims to empower mothers to be role models for their daughters positive health behaviour. Participants in the feasibility study were mothers (n = 27) with daughters (n = 31) aged 12-16 years. Eligibility rates were 93.4%, and baseline activity levels were low. Programme content, measures and facilitators were acceptable. Daily steps increased in mothers (+2,875, p = 0.009) and daughters (+1,393, p = 0.007). Conclusions We demonstrate the value of formative research in the intervention development process. We show that it is feasible to increase the PA levels of teenage girls through an inter-generational multi-component PA programme. The SOLE MATES programme should now be examined for effectiveness using a RCT. If successful the scale-up and sustainability of the programme should be explored.


Background
Young people have the right to be informed and consulted about decisions affecting their lives. Youth Patient and Public Involvement (PPI) should be encouraged to ensure research is carried out 'with' or 'by' young people rather than 'to', 'about' or 'for' them. PPI can ensure research is relevant, results are accessible and recruitment rates are improved. Young people have had limited involvement in the design, implementation and dissemination of public health research and there have been calls for a greater focus on youth PPI in research.

Methods
Following the WISH feasibility study that consulted young people pre and post-intervention, a Youth Advisory Group (YAG) was set up within the main trial. The WISH study is a clustered randomised controlled trial in which a peer-led, school-based, brisk walking intervention is compared to usual physical activity in adolescent females. The YAG was introduced to inform intervention delivery and provide researchers with an understanding of what would encourage/ discourage participation. Schools were asked to invite pupils aged 12-14 years (participants) and 15-18 years (walk leaders). Participative methods were used to develop and review study documentation. The YAG completed a short questionnaire and recruitment rates were monitored.

Results
Fourteen pupils from 3 schools attended the 2019 YAG meeting. The YAG agreed the meeting a good way of getting young people involved in research (93%) and attendees enjoyed the meeting (100%). As a result, changes were made to study documentation, incentives were purchased and recruitment materials developed. Participant recruitment was higher in schools who participated in the YAG (54%) compared to those who did not (47%). In 2021 the second YAG occurred and 1 teacher, 12 participants and 10 walk leaders from 2 schools provided feedback on the trials COVID-19 contingency plan. The girls felt their feedback was valued (100%) and it was important young people had the chance to contribute to research studies (100%).

Conclusions
The views of young people have been central to the development of the WISH Study and although youth PPI is Background Adolescent females Physical Activity (PA) participation rates are low globally, particularly among females of lower Socio-Economic Status (SES). Evidence suggests theory-based, multicomponent interventions are most effective at improving PA levels. This research aimed to co-design, with adolescent females, a theory-driven, multi-component, extracurricular school-based PA intervention, the Girls Active Project (GAP) and assess its feasibility. Setting One single-sex, females-only, designated disadvantaged postprimary school in Dublin, Ireland.

Methods
The Behaviour Change Wheel (BCW) and Public and Patient Involvement (PPI) were used to develop the GAP. Mixedmethods with students (n = 287, aged 12-18) and teachers (n = 7) captured students' self-reported PA levels and identified factors influencing PA behaviour at school. These data were subsequently used in discussion groups with PPI contributors (n = 8, students aged 15-17) to co-design the intervention. Mixed-methods were applied with multiple stakeholders to assess the feasibility of implementing and evaluating the GAP programme over a 12-week single-arm feasibility trial.

Results
Just 1.4% of the students in this sample (n = 287) reported meeting the recommended PA guidelines. Time, social influences, beliefs about capabilities, environmental context and resources, goals, reinforcement, and behavioural regulation emerged from the data as factors influencing PA behaviour. A peer-led, after-school PA programme was codesigned. The feasibility study encountered significant contextual barriers and challenges with recruitment. Recruitment (n = 8, 10%) was low, yet retention (88%) was high. Despite the COVID-19 pandemic hindering implementation, results suggested the GAP programme was implemented with high fidelity (87%), well-received by stakeholders and perceived as compatible with the after school-setting. Conclusions PA levels of females in this sample were far below recommended guidelines for optimum health. The novel approach applied to systematically co-design the intervention could facilitate future replication. Whilst further thought must be given on how to increase enrolment, the in-person delivered PA programme showed promise as an intervention that can be feasibly implemented and evaluated. Future research should examine the GAP's preliminary-effectiveness at increasing PA Background Health promotion efforts have largely failed to effectively support adolescent girls to meet public health guidelines for physical activity (PA). Engaging mothers in the promotion of PA for their daughters is an important strategy to facilitate behaviour change. This paper provides an overview of the development of the SOLE MATES programme -a novel mother-daughter intervention. Methods This programme of research follows the MRC guidance for development and evaluating complex interventions (Craig, 2008). Two reviews were conducted to synthesise the evidence base on (1) mother-daughter PA interventions and (2) adolescent girls' perceptions of PA participation. The behaviour change wheel (BCW) framework was then used to design the components of an intervention to improve adolescent girls' PA (Michie et al, 2011). Finally, a single-arm feasibility trial was conducted to examine recruitment, data collection, acceptability, resources and participant responses.

Results
Our evidence reviews showed that only a limited number of interventions designed exclusively to target mothers and daughters have been conducted. In addition, programmes for adolescent girls should focus on alternative activities aside from the competitive team-based sports often offered.
The BCW design process resulted in a group-based face-to-face intervention, involving six intervention functions (education, persuasion, incentivisation, training, modelling, enablement) and 18 behaviour change techniques. The 6-week programme includes weekly educational and practical group sessions plus home tasks and the provision of participant resources. In addition to encouraging participants to walk regularly, the programme also aims to empower mothers to be role models for their daughters positive health behaviour. Participants in the feasibility study were mothers (n = 27) with daughters (n = 31) aged 12-16 years. Eligibility rates were 93.4%, and baseline activity levels were low. Programme content, measures and facilitators were acceptable. Daily steps increased in mothers (+2,875, p = 0.009) and daughters (+1,393, p = 0.007).

Conclusions
We demonstrate the value of formative research in the intervention development process. We show that it is feasible to increase the PA levels of teenage girls through an intergenerational multi-component PA programme. The SOLE MATES programme should now be examined for effectiveness using a RCT. If successful the scale-up and sustainability of the programme should be explored. Keywords: Adolescent, mother, walking, education, health, female

Background
According to the Elaborated Environmental Stress Hypothesis, anxiety and depression in children are associated with poor motor competence, and these associations may be mediated by social support and self-perceptions. Improving children's motor competence through school-based physical activity interventions may therefore be a mechanism for promoting positive mental health through psychosocial factors. Coproduction provides opportunities to participate in intervention development processes, thereby ensuring that specific needs of stakeholders are targeted. The shared stakeholder ownership of the process provides a context-sensitive basis for acceptable interventions with increased likelihood of them being effectively implemented and resulting in positive outcomes. This presentation describes phase 1 of the Move Well, Feel Good study, which aimed to co-produce and evaluate the feasibility of a primary school physical activity intervention to improve children's motor competence and mental health. Methods Five primary schools were recruited from a low socioeconomic status community in northwest England. From these schools, stakeholder groups were formed consisting of class teachers, school leaders, physical activity specialists, and children (aged 8-9 years). Stakeholders worked in single and multiple stakeholder groups through a 6-stage process aligned to the Double Diamond Design Approach by employing divergent and convergent thinking processes to discover, define, develop, and deliver a solution to the 'problems' of how best to improve children's motor competence and mental health, and how best to facilitate real-world school context implementation of the intervention. Through this process the child and adult stakeholders worked separately in workshops and engaged in additional learning and consensus activities. The adult stakeholder co-production workshops were informed by the children's views and current research evidence. Multiplestakeholder groups worked collaboratively to develop intervention ideas, which were presented, critiqued, and refined in alignment with the TIDieR checklist.

Results
In the final stage of the process the research team presented the final co-produced interventions back to the stakeholders and a consensus vote was taken to decide which intervention would be implemented in the phase 2 feasibility trial in September 2022.

Conclusions
School stakeholders' participation in intervention co-produc-Abstract citation ID: ckac093.032 S06-5 The Walking In ScHools (WISH) study: Development and evaluation of a peer-led schoolbased walking intervention in adolescent girls from pilot to fully-powered trial

Background
Walking interventions, delivered within the school setting, have the potential to increase physical activity (PA) in adolescents. Previous research has shown that walking is an acceptable form of PA for adolescent girls, and that walking interventions may be effective at increasing PA in this group. Findings from the Walking In ScHools (WISH) pilot study (n199 female participants) found the intervention was effective in increasing light intensity PA in adolescent girls, but further research is needed to examine the effects of walking on overall PA and the role of peer leaders in delivering school-based interventions. The present study aims to build upon this pilot work and evaluate the effectiveness of a novel, low-cost, peer-led school-based walking intervention, delivered across the school year, at increasing accelerometer-measured PA levels of adolescent girls.

Methods
The WISH study is a school-based cluster randomised controlled trial targeting adolescent girls (aged 12-14 years) within the post-primary school setting. Data will be collected at four timepoints, baseline, mid-intervention, post-intervention, and 13 months post-baseline. Following baseline data collection, schools were randomly allocated to intervention (n = 9) or control (n = 9). In intervention schools, older pupils (aged 15-18 years) were trained as walk leaders and led the younger girls in 10-15min walks before school, at break, and during lunch, across the school year (20-22 weeks). The primary outcome measure is accelerometer-measured total PA (post-intervention) and secondary outcomes include anthropometry measures, and wellbeing. Results Some 590 participants (mean(SD) age 12.6(0.64)years) were recruited from 18 schools across Northern Ireland (n = 9) and the Border region of the Republic of Ireland (n9). Within the intervention schools, 149 walk leaders were trained. At baseline (n = 535), mean(SD) time spent in moderate to vigorous PA